Medicare Payment Models Could See Reform

The House of Representatives' Energy and Commerce Committee recently released draft legislation that would replace Medicare's current physician payment system with a quality-based system.

The House of Representatives' Energy and Commerce Committee recently released draft legislation that would replace Medicare's current physician payment system with a quality-based system.

ASH reports:

Committees in both the House of Representatives and the Senate continue to work on legislation to reform physician payment in Medicare. On June 28, the House of Representatives' Energy and Commerce Committee released advanced draft legislation to replace Medicare's physician payment system and noted that the Committee plans to vote this summer on legislation. The advanced draft legislation would repeal the current payment formula known as the Sustainable Growth Rate (SGR) and replace it with a quality-based system, while also allowing providers to participate in new delivery models. The legislation also includes proposed payment scenarios for the update incentive program.

The draft legislation builds on detailed proposals House Republican leadership released in April and May. ASH submitted comments to the House Republican leadership in response to the April proposal and additional feedback to the Energy and Commerce Committee on the May draft legislation. ASH’s comments supported repealing of the SGR and replacing the current payment formula with predictable payment rates for at least five years while stakeholders develop a new payment system that combines a base payment rate with a variable rate tied to quality performance.

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